Georgetown University Medical Center has formed a multidisciplinary team including the School of Nursing, three departments from the School of Medicine (Pediatrics, Community and Family Medicine, Obstetrics and Gynecology), Greater Southeast Community Hospital, Providence Hospital, the Community of Hope Health Services, the House of Ruth, Community Health Care (including clinics at Upper Cardozo and East of the River), Community Medical Care, After School Kids (ASK), and the Positive Peers Program. This team represents staff with a broad range of interests and expertise including obstetrics and gynecology, nurse-midwifery, neonatology, pediatrics, family practice, adolescent medicine, child development, children's health promotion, behavioral science and epidemiology, health communication, and implementation and evaluation of community-based programs. Georgetown has a number of programs already in place that support the goals of the cooperative agreement and we would propose building upon and/or expanding some of these existing programs for the purposes of this cooperative agreement. Georgetown would collaborate with NIH staff, with other centers participating in this cooperative agreement and with existing and planned programs to combat the high infant mortality rate in the District of Columbia. Georgetown proposes evaluating the effectiveness of the following types of programs: 1) The development and testing of effective community-based outreach strategies to enhance participation in prenatal care and get women into prenatal care early; 2) The development and testing of a system of prenatal, interconceptional, and preconceptional care with 'enriched' programs for high-risk women; 3) Development and testing of interventions to improve parenting skills and to improve utilization of routine well baby care services, including immunizations and injury prevention; 4) Testing of interventions aimed at preventing preterm delivery or intrauterine growth retardation. Georgetown would also like to consider the implementation of a city-wide networked, on-line computer automated medical record for prenatal/neonatal care as part of the cooperative agreement.